Meta-analysis on randomized controlled trials for scalp acupuncture treatment of stroke:A systematic review
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摘要
OBJECTIVE:To conduct a systematic review to assess the clinical effectiveness of scalp acupuncture(SA) for stroke.METHODS:Literature searches were performed in7 databases up to 16 August 2014,and all the randomized controlled trials(RCTs) in which SA therapy was administered to stroke patients were selected.Methodological quality was assessed using the Jadad score,the Cochrane risk of bias assessment,and the Standards for Reporting Interventions in Clinical Trials of Acupuncture.RESULTS:Of a total of 2086 papers,21 RCTs were selected.Meta-analysis revealed significant differences in the total efficacy rates of the SA group and the body acupuncture(BA) group vs the medication group(P < 0.002,P < 0.000 001,respectively),the SA plus BA group vs the BA group(P < 0.001);in the motor function of the SA plus BA group vs the BA group(P = 0.077);and in the nerve function of the SA group vs the SA plus BA group(P < 0.0001).CONCLUSION:The results of our systematic review showed that SA therapy may exhibit effects in treatment efficacy and in the recovery of motor and nervous functions in patients with acute to chronic stroke.However,because of the lack of methodological quality,the thoroughly planned clinical studies are still required.
OBJECTIVE:To conduct a systematic review to assess the clinical effectiveness of scalp acupuncture(SA) for stroke.METHODS:Literature searches were performed in7 databases up to 16 August 2014,and all the randomized controlled trials(RCTs) in which SA therapy was administered to stroke patients were selected.Methodological quality was assessed using the Jadad score,the Cochrane risk of bias assessment,and the Standards for Reporting Interventions in Clinical Trials of Acupuncture.RESULTS:Of a total of 2086 papers,21 RCTs were selected.Meta-analysis revealed significant differences in the total efficacy rates of the SA group and the body acupuncture(BA) group vs the medication group(P < 0.002,P < 0.000 001,respectively),the SA plus BA group vs the BA group(P < 0.001);in the motor function of the SA plus BA group vs the BA group(P = 0.077);and in the nerve function of the SA group vs the SA plus BA group(P < 0.0001).CONCLUSION:The results of our systematic review showed that SA therapy may exhibit effects in treatment efficacy and in the recovery of motor and nervous functions in patients with acute to chronic stroke.However,because of the lack of methodological quality,the thoroughly planned clinical studies are still required.
OBJECTIVE:To conduct a systematic review to assess the clinical effectiveness of scalp acupuncture(SA) for stroke.METHODS:Literature searches were performed in7 databases up to 16 August 2014,and all the randomized controlled trials(RCTs) in which SA therapy was administered to stroke patients were selected.Methodological quality was assessed using the Jadad score,the Cochrane risk of bias assessment,and the Standards for Reporting Interventions in Clinical Trials of Acupuncture.RESULTS:Of a total of 2086 papers,21 RCTs were selected.Meta-analysis revealed significant differences in the total efficacy rates of the SA group and the body acupuncture(BA) group vs the medication group(P < 0.002,P < 0.000 001,respectively),the SA plus BA group vs the BA group(P < 0.001);in the motor function of the SA plus BA group vs the BA group(P = 0.077);and in the nerve function of the SA group vs the SA plus BA group(P < 0.0001).CONCLUSION:The results of our systematic review showed that SA therapy may exhibit effects in treatment efficacy and in the recovery of motor and nervous functions in patients with acute to chronic stroke.However,because of the lack of methodological quality,the thoroughly planned clinical studies are still required.
引文
1 Korean Stroke Society.Textbook of Stroke.Seoul:Epublic,2009:57.
2 He J,Gu DF,Wu XG,et al.Major causes of death among men and women in China.N Engl J Med 2005;353(110):1124-1134.
3 Feigin VL.Stroke epidemiology in the developing world.Lancet 2005;365(9478):2160-2161.
4 Gorelick PB,Sacco RL,Smith DB,et al.Prevention of a first stroke:a review of guidelines and a multidisciplinary consensus statement from the national stroke association.JAMA 1999;281(12):1112-1120.
5 Rhee WH,Kim JS.A review study of cerebrovascular disease in Korea.Korean J Epidemiol 1981;3(1):1-22.
6 Ha CH,Han SG,Cho MR,Ryu CR,Lee BR.A clinical study on 29 cases with stroke treated by common acupuncture therapy and scalp acupuncture.J Korean Acupunct Moxibust Soc 2001;18(4):82-90.
7 The Korean Acupuncture and Moxibustion Society Textbook Publishing Community.The textbook of acupuncture and moxibustion(Vol.2).Kyeong gi:Jipmundang,2008:41,51,68,308.
8 The Korean acupuncture and moxibustion society textbook publishing community.The textbook of acupuncture and moxibustion.Seoul:Jipmoondang,2012:137-145,159-170,234,287,290,308-317,340.
9 Zhao HL,Guo WR.Clinical application of scalp and ear acupuncture.Beijing:China Antique Book Publishing Company,1999:12,39-41,46,53,61-62.
10 Kim JH,Park GC.A case report of central post-stroke pain patient treated with SA(MS6 and MS7)and usual treatment of Korean medicine.J Korean Acupuncture&Moxibustion Society 2014;31(3):57-65.
11 Han HJ,Kim MJ,Jang IS,Kang SY.A case study of stroke patients with hemiparesis treated by catgut-embedding therapy on scalp acupoints.J Korean Orient Int Med2013;34(3):312-321.
12 Beak KM,Kim MJ,Lee HU,et al.A clinical study of 3cases of stroke patients with dysphagia treated by simultaneous scalp-acupuncture and electroacupuncture.J Korean Orient Int Med 2007;28(3):632-644.
13 Cho TS,Son IS,Park IB,et al.Effects of SA on shortterm NIHSS and MBI in stroke patients.J Korean Orient Med 2003;24(1):65-73.
14 Wang Y,Shen J,Wang XM,et al.Scalp acupuncture for acute ischemic strokes:A Meta-analysis of randomized controlled trials.Evid Based Complement Alternat Med2012;2012:Article ID 480950.
15 Lee SJ,Shin BC,Lee MS,Han CH,Kim JI.Scalp acupuncture for stroke recovery:A systematic review and Meta-analysis of randomized controlled trials.Eur J Integr Med 2013;5(2):87-99.
16 Kong JC,Lee MS,Shin BC,Song YS,Ernst E.Acupuncture for functional recovery after stroke:a systematic review of sham-controlled randomized clinical trials.CMAJ2010;182(16):1723-1729.
17 Kim JY,Kim JY,Kim NS,et al.Review on clinical trials for acupuncture treatment of chemotherapy-induced toxicity in Pubmed database.J Korean Acupuncture&Moxibustion Society 2013;30(2):43-53.
18 Higgins JPT,Altman DG.In:Cochrane Handbook for Systematic Reviews of Interventions.Higgins JPT,Green S,editor.Chichester:John Wiley&Sons Ltd;2008.Chapter 8:assessing risk of bias in included studies;pp.187-241.
19 Lee HS,Park JB,Seo JC,Park HJ,Lee HJ.Standards for reporting interventions in controlled trials of acupuncture:The STRICTA recommendations.J Korean Acupuncture&Moxibustion Society 2002;19(6):134-154.
20 Kim WY,Lee SD,Lim BM,Kim KS.The assessment of appropriateness of acupuncture methodology based on STRICTA recommendations.J Korean Acupuncture&Moxibustion Society 2007;24(5):151-170.
21 Liu S,Shi ZY.Observation on the therapeutic effect of SAand body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke.World J Acupuncture Moxibustion 2013;23(1):21-26.
22 Qiu YL.Clinical observation on SA combined with rehabilitation training for hemiplegia after stroke.J Acupunct Tuina Sci 2013;11(4):226-229.
23 Shi HF,Zheng XH.Effect of SA drawing method on motor function in hemiplegic patients following cerebral thrombosis at convalescent period.Chin J Integr Med2007;27(4):361-363.
24 Sun H,Bao F,Wang DH,Zhang YX,Wang FQ.Observation on clinical therapeutic effect of SA combined with body acupuncture on apoplectic hemiplegia.Zhong Guo Zhen Jiu 2006;26(6):395-398.
25 Li H,Hou ZW,Bai YL,Gu SZ.Comparison of the therapeutic effects among scalp-,body-acupuncture and scalpplus body-acupuncture in the treatment of 230 cases of stroke.Zhen Ci Yan Jiu 2006;31(3):169-172.
26 Zhao DG,Mu JP.Clinical study on SA combined with sports therapy for rehabilitation of poststroke hemiplegia.Zhong Guo Zhen Jiu 2005;25(1):19-20.
27 Zhou SB,Lu D,Huang F,Zhang WQ,Wei XP.Effect of Wenshen Huoxue decoction combined with scalp aucpuncture on acute cerebral infarction and effect on CRP,UA,FIB.Mod J Integr Chin Trad West Med 2013;10:1027-1029.
28 Bao F,Wang DH,Zhang YX,Wang FQ,Sun H.Comparison of therapeutic effects between body acupuncture and SA combined with body acupuncture on atherosclerotic cerebral infarction at acute stage.Zhong Guo Zhen Jiu2008;28(1):10-12.
29 Yu CD,Wu BH,Zhang J,Song HM,Wang GS,Yu Z.Effect of skull acupuncture and SA on serum vascular endothelial growth factor in the patient of acute cerebral infarction.Zhong Guo Zhen Jiu 2006;26(7):466-468.
30 Yu CD,Wu BH,Hong AH,Bei JY,Yu Z.Changes of serum MDA content and neurological rehabilitation in cerebral infarction patients treated with scalp-acupuncture plus medication.Acupuncture Research 2004;3:222-226.
31 Wu XP,Yang YH,Wang YW,Wang SJ,Liu YX.Clinical observation on the treatment of acute cerebral infarction with scalp-acupuncture.World J Acupuncture Moxibustion 2001;11(3):24-27.
32 Hsing WT,Imamura M,Weaver K,Fregni F,Azevedo Neto RS.Clinical effects of scalp electrical acupuncture in stroke:A sham-controlled randomized clinical trial.J Altern Complement Med 2012;18(4):341-346.
33 Tang X,Tang CL,Xu FM,Xie HW,Li LM,Song YE.Effect of SA combined with body acupuncture on limb function in subacute stroke patients.Zhen Ci Yan Jiu 2012;37(6):488-492.
34 Hegyi G,Szigeti GR.Rehabilitation of stroke patients using Yamamoto new SA:A pilot study.J Altern Complement Med 2012;18(10):971-977.
35 Zhou W,Liu H,Wang LP,et al.Effect of alternative administration of scalp-acupuncture,body-acupuncture and abdominal-acupuncture on the upper-limb dyscinesia in patients with stroke.Zhen Ci Yan Jiu 2009;34(2):128-131.
36 Wang BB,Zhou P,Zhu YP.Observation on therapeutic effect of SA combined with body acupuncture on stroke.Zhong Guo Zhen Jiu 2005;25(4):240-242.
37 Tan JL,Li GH.Controlled study on body acupuncture and scalp acupuncture for treatment of ischemic apoplexy.J Chinese Acupuncture&Moxibustion 2004;6:371-373.
38 Li YK,Chen XJ.Study on scalp electroacupunture treatment of apoplexy and its influence on hemorheology in ischemic apoplexy patients.World J Acupuncture moxibustion 2001;11(4):18-22.
39 Yu CD,Wu BH,Bai JY,Zhang J,Yu Z.Clinical study on needling skull suture plus medicine for treatment of acute cerebral infarction.Zhong Guo Zhen Jiu 2004;24(5):329-332.
2 He J,Gu DF,Wu XG,et al.Major causes of death among men and women in China.N Engl J Med 2005;353(110):1124-1134.
3 Feigin VL.Stroke epidemiology in the developing world.Lancet 2005;365(9478):2160-2161.
4 Gorelick PB,Sacco RL,Smith DB,et al.Prevention of a first stroke:a review of guidelines and a multidisciplinary consensus statement from the national stroke association.JAMA 1999;281(12):1112-1120.
5 Rhee WH,Kim JS.A review study of cerebrovascular disease in Korea.Korean J Epidemiol 1981;3(1):1-22.
6 Ha CH,Han SG,Cho MR,Ryu CR,Lee BR.A clinical study on 29 cases with stroke treated by common acupuncture therapy and scalp acupuncture.J Korean Acupunct Moxibust Soc 2001;18(4):82-90.
7 The Korean Acupuncture and Moxibustion Society Textbook Publishing Community.The textbook of acupuncture and moxibustion(Vol.2).Kyeong gi:Jipmundang,2008:41,51,68,308.
8 The Korean acupuncture and moxibustion society textbook publishing community.The textbook of acupuncture and moxibustion.Seoul:Jipmoondang,2012:137-145,159-170,234,287,290,308-317,340.
9 Zhao HL,Guo WR.Clinical application of scalp and ear acupuncture.Beijing:China Antique Book Publishing Company,1999:12,39-41,46,53,61-62.
10 Kim JH,Park GC.A case report of central post-stroke pain patient treated with SA(MS6 and MS7)and usual treatment of Korean medicine.J Korean Acupuncture&Moxibustion Society 2014;31(3):57-65.
11 Han HJ,Kim MJ,Jang IS,Kang SY.A case study of stroke patients with hemiparesis treated by catgut-embedding therapy on scalp acupoints.J Korean Orient Int Med2013;34(3):312-321.
12 Beak KM,Kim MJ,Lee HU,et al.A clinical study of 3cases of stroke patients with dysphagia treated by simultaneous scalp-acupuncture and electroacupuncture.J Korean Orient Int Med 2007;28(3):632-644.
13 Cho TS,Son IS,Park IB,et al.Effects of SA on shortterm NIHSS and MBI in stroke patients.J Korean Orient Med 2003;24(1):65-73.
14 Wang Y,Shen J,Wang XM,et al.Scalp acupuncture for acute ischemic strokes:A Meta-analysis of randomized controlled trials.Evid Based Complement Alternat Med2012;2012:Article ID 480950.
15 Lee SJ,Shin BC,Lee MS,Han CH,Kim JI.Scalp acupuncture for stroke recovery:A systematic review and Meta-analysis of randomized controlled trials.Eur J Integr Med 2013;5(2):87-99.
16 Kong JC,Lee MS,Shin BC,Song YS,Ernst E.Acupuncture for functional recovery after stroke:a systematic review of sham-controlled randomized clinical trials.CMAJ2010;182(16):1723-1729.
17 Kim JY,Kim JY,Kim NS,et al.Review on clinical trials for acupuncture treatment of chemotherapy-induced toxicity in Pubmed database.J Korean Acupuncture&Moxibustion Society 2013;30(2):43-53.
18 Higgins JPT,Altman DG.In:Cochrane Handbook for Systematic Reviews of Interventions.Higgins JPT,Green S,editor.Chichester:John Wiley&Sons Ltd;2008.Chapter 8:assessing risk of bias in included studies;pp.187-241.
19 Lee HS,Park JB,Seo JC,Park HJ,Lee HJ.Standards for reporting interventions in controlled trials of acupuncture:The STRICTA recommendations.J Korean Acupuncture&Moxibustion Society 2002;19(6):134-154.
20 Kim WY,Lee SD,Lim BM,Kim KS.The assessment of appropriateness of acupuncture methodology based on STRICTA recommendations.J Korean Acupuncture&Moxibustion Society 2007;24(5):151-170.
21 Liu S,Shi ZY.Observation on the therapeutic effect of SAand body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke.World J Acupuncture Moxibustion 2013;23(1):21-26.
22 Qiu YL.Clinical observation on SA combined with rehabilitation training for hemiplegia after stroke.J Acupunct Tuina Sci 2013;11(4):226-229.
23 Shi HF,Zheng XH.Effect of SA drawing method on motor function in hemiplegic patients following cerebral thrombosis at convalescent period.Chin J Integr Med2007;27(4):361-363.
24 Sun H,Bao F,Wang DH,Zhang YX,Wang FQ.Observation on clinical therapeutic effect of SA combined with body acupuncture on apoplectic hemiplegia.Zhong Guo Zhen Jiu 2006;26(6):395-398.
25 Li H,Hou ZW,Bai YL,Gu SZ.Comparison of the therapeutic effects among scalp-,body-acupuncture and scalpplus body-acupuncture in the treatment of 230 cases of stroke.Zhen Ci Yan Jiu 2006;31(3):169-172.
26 Zhao DG,Mu JP.Clinical study on SA combined with sports therapy for rehabilitation of poststroke hemiplegia.Zhong Guo Zhen Jiu 2005;25(1):19-20.
27 Zhou SB,Lu D,Huang F,Zhang WQ,Wei XP.Effect of Wenshen Huoxue decoction combined with scalp aucpuncture on acute cerebral infarction and effect on CRP,UA,FIB.Mod J Integr Chin Trad West Med 2013;10:1027-1029.
28 Bao F,Wang DH,Zhang YX,Wang FQ,Sun H.Comparison of therapeutic effects between body acupuncture and SA combined with body acupuncture on atherosclerotic cerebral infarction at acute stage.Zhong Guo Zhen Jiu2008;28(1):10-12.
29 Yu CD,Wu BH,Zhang J,Song HM,Wang GS,Yu Z.Effect of skull acupuncture and SA on serum vascular endothelial growth factor in the patient of acute cerebral infarction.Zhong Guo Zhen Jiu 2006;26(7):466-468.
30 Yu CD,Wu BH,Hong AH,Bei JY,Yu Z.Changes of serum MDA content and neurological rehabilitation in cerebral infarction patients treated with scalp-acupuncture plus medication.Acupuncture Research 2004;3:222-226.
31 Wu XP,Yang YH,Wang YW,Wang SJ,Liu YX.Clinical observation on the treatment of acute cerebral infarction with scalp-acupuncture.World J Acupuncture Moxibustion 2001;11(3):24-27.
32 Hsing WT,Imamura M,Weaver K,Fregni F,Azevedo Neto RS.Clinical effects of scalp electrical acupuncture in stroke:A sham-controlled randomized clinical trial.J Altern Complement Med 2012;18(4):341-346.
33 Tang X,Tang CL,Xu FM,Xie HW,Li LM,Song YE.Effect of SA combined with body acupuncture on limb function in subacute stroke patients.Zhen Ci Yan Jiu 2012;37(6):488-492.
34 Hegyi G,Szigeti GR.Rehabilitation of stroke patients using Yamamoto new SA:A pilot study.J Altern Complement Med 2012;18(10):971-977.
35 Zhou W,Liu H,Wang LP,et al.Effect of alternative administration of scalp-acupuncture,body-acupuncture and abdominal-acupuncture on the upper-limb dyscinesia in patients with stroke.Zhen Ci Yan Jiu 2009;34(2):128-131.
36 Wang BB,Zhou P,Zhu YP.Observation on therapeutic effect of SA combined with body acupuncture on stroke.Zhong Guo Zhen Jiu 2005;25(4):240-242.
37 Tan JL,Li GH.Controlled study on body acupuncture and scalp acupuncture for treatment of ischemic apoplexy.J Chinese Acupuncture&Moxibustion 2004;6:371-373.
38 Li YK,Chen XJ.Study on scalp electroacupunture treatment of apoplexy and its influence on hemorheology in ischemic apoplexy patients.World J Acupuncture moxibustion 2001;11(4):18-22.
39 Yu CD,Wu BH,Bai JY,Zhang J,Yu Z.Clinical study on needling skull suture plus medicine for treatment of acute cerebral infarction.Zhong Guo Zhen Jiu 2004;24(5):329-332.